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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 17 0000. ref SDS 16 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040507 -
040508 -
040509 -
040511 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - During treatment yesterday at UCSF, ref SDS 18 354G, Millie received
040902 - blood test on 071017 at Kaiser, ref SDS 17 OS5K,
040904 -  ..
040905 - Since the test does not report results for the cancer marker CA 15-3,
040906 - nor NEUTS, which is ANC for Kaiser, ref SDS 18 FH4H, Millie sent a
040907 - letter to Jackie today....
040908 -
040909 -    1.  Subject: Blood Tests October 17th
040910 -        Date: Fri, 19 Oct 2007 12:53:25 -0700
040916 -         ..
040917 -    2.  Jackie,
040919 -         ..
040920 -    3.  Thanks for coordinating to get test results yesterday for the
040921 -        labs done at Kaiser the day before on 071017, per your letter
040922 -        on the 17th. ref SDS 17 C49J
040924 -         ..
040925 -    4.  Please submit CA 15-3, which typically is available from the
040926 -        Kaiser lab on same day or the day after blood draws.
040928 -         ..
040929 -    5.  Would also like NEUTS, which Kaiser calls ANC.  It was not
040930 -        listed in the report I received yesterday, as it normally
040931 -        appears on UCSF test reports.
040932 -
040934 -         ..
040935 -        Work Resumption Requires Assessment Patient Condition
040936 -
040938 -         ..
040939 -    6.  I'm thinking of going back to work (to forget about all this
040940 -        billing stuff).  I feel good, and the exam yesterday seemed
040941 -        positive, ref SDS 18 EP5F, along with the last scan.
040942 -        ref SDS 18 4N7K  CA 15-3 and NEUTS (ANC) are the other figures
040943 -        in the calculus.
040944 -
040945 -            [On 071022 Millie's letter to Kaiser reports consideration
040946 -            of returning to work based on medical condition.
040947 -            ref SDS 19 F64M
040949 -             ..
040950 -            [On 071022 primary care physician at Kaiser reported CA
040951 -            15-3 cancer marker rises to 74; recommends Doctor Rugo at
040952 -            UCSF review considerations returning to work. ref SDS 20
040953 -            GL3G
040954 -
040956 -         ..
040957 -    7.  Thanks very much.
040959 -         ..
040960 -    8.  Millie
040961 -
040963 -  ..
0410 -
0411 -
0412 - 1344
0413 -
041301 - Blood Test Confuse Neutrophil for NEUTS Evaluate Safety of Treatment
041302 -
041303 -
041304 - Jackie responded to Millie's letter this morning, saying...
041305 -
041306 -    1.  Subject:  Blood Tests October 17th
041307 -        Date: Fri, 19 Oct 2007 13:03:54 -0700
041313 -         ..
041314 -    2.  Dear Millie,
041316 -         ..
041317 -    3.  Glad you are feeling well.  Once we receive a fax from Kaiser
041318 -        which shows the CA 15.3, we can let you know.  The neutrophil
041319 -        count is listed at the bottom of the page.
041321 -         ..
041322 -    4.  Thanks
041323 -        Jackie
041325 -  ..
041326 - UCSF seems to confuse in this letter neutrophil in Kaiser's report,
041327 - received yesterday on 071018, ref SDS 18 QK4L, for NEUTS at UCSF which
041328 - correlates to ANC at Kaiser and comprises a composite calculation,
041329 - reported on 071018. ref SDS 18 6N9M
041330 -
041331 -
041333 -  ..
0414 -
0415 -
0416 - 1357
0417 -
041701 - Millie sent a letter to UCSF explaining NEUTS requirements, and
041702 - saying...
041703 -
041704 -    1.  Subject: NEUTS at UCSF = ANC at Kaiser Blood Tests October 17th
041705 -        Date: Fri, 19 Oct 2007 14:04:46 -0700
041709 -        "Phillips, Arlette"
041711 -         ..
041712 -    2.  Jackie,
041714 -         ..
041715 -    3.  Your letter today responding to a request for ANC and NEUTS
041716 -        references "neutrophil" count at the bottom of the report for
041717 -        the blood test at Kaiser on 071017. [received from UCSF on
041718 -        071018, ref SDS 18 QK4L]  Kaiser's report lists "Neutorphils
041719 -        36%, and reports this is low (L) relative to the range of 41 -
041720 -        81.  This triggers alert that NEUTS and ANC might be low as
041721 -        well.  In the past NEUTS and ANC are presented as absolute
041722 -        figures, rather than percentages, e.g., see the test on 070524.
041723 -        ref SDS 4 P560
041725 -         ..
041726 -    4.  The test result at UCSF would be something like 1.4, 2.3, that
041727 -        kind of thing, and the equivalent at Kaiser would be 1400,
041728 -        2300.
041730 -         ..
041731 -    5.  It gets a little confusing mixing and matching units of measure
041732 -        and ranges between Kaiser and UCSF.  I'm pretty sure that
041733 -        neutrophils at the bottom of the Kaiser lab is not the same as
041734 -        NEUTS in the UCSF report, though it may be a component of the
041735 -        calculation for NEUTS (and ANC at Kaiser).
041736 -
041737 -            [On 090420 1451 Doctor Mason at Kaiser Outside Referrals
041738 -            feels doctors are trained to convert units of measure and
041739 -            ranges between lab diagnostics, and so confusion does not
041740 -            present a risk for medical mistakes for referrtal patients.
041741 -            ref SDS 22 Q59V
041743 -         ..
041744 -        If we can get ANC from Kaiser, that will tell us NEUTs for UCSF
041745 -        (I hope).
041747 -         ..
041748 -    6.  Thanks.
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0418 -